A German study just published by Moritz and colleagues provides an interesting insight into antipsychotic drugs used in the treatment of schizophrenia and other psychotic illnesses. Data was collected by asking psychiatric patients to complete a questionnaire about their experiences in taking antipsychotic medication for their mental disorder. The conclusion was that such drugs are effective because they dampen emotion rather than treating any specific symptoms. ‘Doubt, numbing and withdrawal were the main subjective antipsychotic effects’. Basically such drugs just keep patients quiet – an effect which many patients find unpleasant. One reviewer says ‘It is clear we need better ways to help people’.
Posts tagged with schizophrenia
A few months ago there was an item on this blog about the comments on AQA A markschemes that stated that answers using psychoanalysis as a psychological therapy for schizophrenia would be unlikely to gain high marks. We do not believe this is a justifiable position. However, regardless of whether the board is right or wrong in their position, we plan to update our textbook to include a different therapy – family intervention. We also are providing a copy of this insert free, click family intervention to download.
PSYA4 June 2012 had a question which asked ‘Outline one biological therapy and one psychological therapy for schizophrenia.’
The mark scheme included the following: ‘Therapies such as psychoanalysis and psychosurgery have been used for schizophrenia in the past but are no longer generally considered suitable. A general outline of these techniques which are not made explicitly relevant to schizophrenia cannot achieve higher than rudimentary.’
In our A2 textbook we have included psychoanalysis as a therapy that can be used for schizophrenia. One reader asked us about this. Our reply was:
1. The mark scheme does not say that answers related to psychoanalysis would receive a poor mark. It says that answers that do not relate psychoanalysis to schizophrenia would attract a poor mark.
2. NICE guidelines updated 2010 discuss the use of psychoanalysis and psychodynamic therapies for schizophrenia. See page 310 of the document.
3. We reported recent research that suggests that the value of psychoanalysis/psychodynamic therapies has been undervalued (see here).
4. The real problem is that therapies in the real world rarely follow just one perspective. Specifications force us to discuss them in this way.
So we feel justified in including it in our book – but would welcome comments from readers or indeed, from AQA.
The American Psychiatric Association (APA) has been arguing in favour of ECT as a safe treatment for severe mental illness, according to a short piece in the current issue of the BPS magazine The Psychologist. The APA claims that ECT is effective 80% of the time and there is no evidence for any associated brain damage.
On the other hand a recent review by Bentall and Read (2010, see here) concluded that any benefits of ECT, when they arise, are minimal, short-lived and come with a significant risk of memory impairment and a slight risk of death. This conclusion was based on a review of studies over the last 60 years where the use of ECT for depression or schizophrenia was compared to a placebo control procedure. Bentall and Read’s final word is that the evidence is so poor that it’s use cannot be scientifically-justified.
Three recent small studies (see here or here) looked at the effects of various 12-16 week exercise programmes on sufferers from schizophrenia. The types of exercise varied from more physically strenuous ones, such as strength training and jogging, to less energetic yoga.
There were small improvements in physical health but greater improvements were found in mental states. Improvements in anxiety and depression from exercise were greater than similar improvements in standard care without an exercise component.
These studies support the findings of two earlier studies, which suggests the importance of further research into the effects of exercise programmes in the treatment of schizophrenia plus initiatives looking into how to implement such programmes and engage sufferers in taking part.
DNA analysis of thousands of people in three separate studies has shown that the disorder is linked to the interaction of a large number of genetic variants on chromosome 6, in an area called the Major Histocompatability Complex which has one role in the immune system and another in controlling the switching on or off of other genes.
How many variants are there? Well, over 30,000 were identified as being much more common in schizophrenics than non-schizophrenics apart from people with bipolar disorder.
So not only is the genetics of schizophrenia far more complex than had been thought, environmental influences are also involved, but there could be a previously unexpected overlap between the two psychopathologies, schizophrenia and bipolar disorder (manic depression).